Anderson David R, Barnes David
Department of Medicine, Dalhousie University and Capital Health, Halifax, Nova Scotia, Canada.
Semin Nucl Med. 2008 Nov;38(6):412-7. doi: 10.1053/j.semnuclmed.2008.07.003.
The role of ultrasonography of the lower extremities for the evaluation of patients with suspected pulmonary embolism has become more clearly defined with time. Ultrasonography is a useful first-line test for pulmonary embolism in clinical circumstances in which radiographic imaging is contraindicated or not readily available (eg, pregnancy). Ultrasonography is likely not required for the evaluation of patients with suspected pulmonary embolism who have a negative computed tomography pulmonary angiography, particularly if there are no symptoms of deep vein thrombosis. Ultrasonography is helpful to exclude a diagnosis of deep vein thrombosis in patients who have nondiagnostic ventilation-perfusion scans. For patients with nondiagnostic ventilation-perfusion scans and negative ultrasonography who are considered clinically highly likely to have pulmonary embolism, it is recommended that computed tomography pulmonary angiography be performed.
随着时间的推移，下肢超声检查在疑似肺栓塞患者评估中的作用已变得更加明确。在放射成像检查禁忌或难以进行（如妊娠）的临床情况下，超声检查是肺栓塞有用的一线检查方法。对于计算机断层扫描肺动脉造影结果为阴性的疑似肺栓塞患者，可能无需进行超声检查，特别是如果没有深静脉血栓形成的症状。超声检查有助于排除通气/灌注扫描结果不明确的患者的深静脉血栓形成诊断。对于通气/灌注扫描结果不明确且超声检查为阴性但临床高度怀疑患有肺栓塞 的患者，建议进行计算机断层扫描肺动脉造影。
